Medical Timeline

Late-2010	Left cervical lymph node is enlarged to approximately 2cm x 2cm. It is located just below the corner of my jaw about an inch below my ear. My left supraclavicular lymph node is also slightly enlarged. I believe them to be associated with a tooth infection that I had at the time. Both seem to resolve over a few months time. However, as I know now, the supraclavicular may have still been slightly larger than 1cm x 1cm.
11/1/11	Dental exam for mild tooth pain in lower left jaw shows a severe infection under the two teeth that will be extracted. Note: I believe that both the same two lymph nodes (cervical and supraclavicular) were enlarged at this point.
1/5/12	Dental surgery appointment followed by a prescription of AMOXICILLIN 500 MG CAPSULE, qty: 21 Antibiotics do not cause the cervical lymph node to resolve (go back to normal size).
1/16/12	Follow-up for suture removal. Surgical procedure is successful and the gums are healing well.
3/12/12	Routine yearly physical examination. Recommendation is to get cervical lymph node checked by personal physician if not resolved within a month. Complete blood count and metabolic panel are normal.
6/14/12	Consultation with my new general practitioner (GP) to discuss my enlarged lymph node. Left supraclavicular lymph node is found to be slightly enlarged. Doctor requests another CBC and also prescribes antibiotics to see if the lymph node fully resolves. Prescription: AMOX TR-K CLV 875-125 MG TAB, (Generic Equivalent for AUGMENTIN 875-125 TABLET ), qty: 28.
6/29/12	Follow-up call with GP. Lymph node is not resolved after completing the antibiotics. Next step is a fine needle aspiration/biopsy.
7/9/12	Fine needle aspiration/biopsy performed followed by a biopsy pathology. Initial slide stain during biopsy looks good, normal and healthy lymphocytes.
7/12/12	Fine needle biopsy results returned to GP. Results are somewhat inconclusive and show the presence of “rare large atypical lymphoid cells, some of which have a binucleate appearance.” GP then refers me to a surgeon for an excisional biopsy consultation.
7/15/12	In preparation for a follow-up dental procedure I am prescribed (1) CHLORHEXIDINE 0.12% RINSE, (Generic Equivalent for PERIDEX 0.12% liquid) and (2) AMOXICILLIN 500 MG CAPSULE, qty: 21 Neither has an effect on reducing the size of the enlarged lymph nodes.
7/31/12	Referral appointment to oncological surgeon in the same hospital network as GP. This is to get a second opinion for an excisional biopsy. Doctor initially recommends a fine needle biopsy. When I tell him that I’ve just had one he then recommends the excisional biopsy of an alternate lymph node, possibly under right armpit. He believes the existing state of the enlarged cervical lymph node may produce a confusing result.  Not a very positive meeting for me. Time for a real second opinion.
Early August 2012	Time for an extended vacation and time for some real research for a recognized lymphoma specialist.
8/29/12	Met with Dr. Eric J. Seifter today for approximately an hour. This included an initial discussion of the package I sent via email. It also included an exam and follow-up consult on the path forward.  Surgery appointment was scheduled as well as the required pre-op tests including two blood tests and an EKG. Results of the needle biopsy indicate we need to perform an excisional biopsy (surgery to remove the enlarged lymph node).
9/12/12	Had a 30-minute pre-op consultation with Dr. Wayne Koch at the JHU Outpatient Center to look at candidate lymph nodes and explain the surgical procedure. The decision is to perform an excisional biopsy on the enlarged, left cervical lymph node.
9/13/12	Excisional biopsy surgery that included about 2 hours of pre-op, a 30-minute procedure, and two hours of post-op. I was awake for the surgery and lightly sedated. Saw the primary offending lymph node once it was removed and it didn’t look like much – a small (1-inch long) pinkish/red fleshy mass.
9/20/12	Pathology results returned to Dr. Koch.
9/21/12	Hodgkin’s Lymphoma diagnosis is confirmed by Dr. Seifter.  Preferred treatment is ABVD, which is the following 4 drugs: Adriamycin, Bleomycin, Vinbalstine, and Dacarbazine. Three additional tests are immediately scheduled for the following week: (1) CT/PET scan for staging HL , (2) pulmonary baseline (lung function test since Bleomycin can affect lung tissue), and (3) an echocardiogram for a heart baseline – a heart scan with ultrasound (since Adriamycin can affect the heart). (link to results)
9/24/12	PET/CT scan at American Radiology.
9/25/12	PET/CT Results. Dr. Seifter called to confirm Stage 3A HL. (link to page)
9/27/12	Echocardiogram at JHU Greenspring Facility.
9/27/12	Chemotherapy consultation and question/answer session with Dr. Seifter. Both Jen and I went and asked all of the questions we’ve been gathering from reading, family and friends. We also met part of the chemotherapy nursing team – Anna Recchio and her son Chris.
9/27 12	Flu shot – I got one at the chemotherapy facility since it’s that time of the year and I can get it out of the way now.
9/28/12	Pulmonary function test at the Pulmonary Lab in the JHU Outpatient Center.
10/9/12	Start Allopurinol (300mg tablet). One tablet per day for 14 days.
10/12/12	Chemotherapy #1 at 9:00am. ABVD intravenous drip. Dacarbazine is the first and takes about an hour. The other three (pushed through by the nurse over the next 60 minutes.
10/23/12	CBC at Park Medical Associates prior to Chemotherapy #2 to see how I’m responding.
10/25/12	Chemotherapy #2 at 10:00am.
11/7/12	PFT #2 at JHU Outpatient Center.
11/9/12	Chemotherapy #3 at 10:00am.
11/26/12	Chemotherapy #4 at 10:30am.
12/5/12	PET/CT #2 at American Radiology.
12/6/12	PFT #3 at JHU Outpatient Center.
12/7/12	Chemotherapy #5 at 10:00am.
12/21/12	Chemotherapy #6 at 10:00am.
12/27/12	PFT #4 at JHU Outpatient Center.
1/4/13	Chemotherapy #7 at 10:00am.
1/16/13	PFT #5 at JHU Outpatient Center.
1/18/13	Chemotherapy #8 at 9:00am.
2/1/13	Chemotherapy #9 at 9:00am.
2/14/13	PFT #6 at JHU Outpatient Center.
2/15/13	Chemotherapy #10 at 9:00am.
3/1/13	Chemotherapy #11 at 9:00am.
3/15/13	Chemotherapy #12 at 9:00am (hopefully the last!).
4/26/13	PET/CT #2 at American Radiology.
6/21/13	First post-chemo check-up with Dr. Seifter (every 3 months for year #1)
10/4/13	Second post-chemo check-up with Dr. Seifter (every 3 months for year #1)
1/17/14	Third post-chemo check-up with Dr. Seifter (every 3 months for year #1)
4/25/14	Fourth post-chemo check-up with Dr. Seifter (every 3 months for year #1)
9/15/14	Fifth post-chemo check-up with Dr. Seifter (every 4 months for year #2)
1/16/14	Sixth post-chemo check-up with Dr. Seifter (every 4 months for year #2)